California grades health care insurance

Everyone knows that sometimes we can get away with something less than the best. Most people would love to own a luxury car, but have to settle for something that fits their finances. Generic cereals aren’t always the same as the name brands, but often the budget requires some compromise.

There’s one thing people shouldn’t have to compromise on, though: the quality of their health care. Insurance companies shouldn’t be in the business of paying for anything less than the best medical care.

That’s why California is leading the nation in grading the quality of care that health insurers offer, and making those grades public for all to see. I have just released the second annual PPO Quality of Care report card.

And the results are not good.

California’s insurers sit at the middle of the pack, nationally, when it comes to delivering quality care to patients. On a scale of one to four stars, our major insurers all got two, or at most three stars, overall. And all of the plans except one got lower grades this year than last year.

But that’s not the worst news. This year we also graded customer satisfaction, and if you’re not happy with your insurer, you’re not alone. Every major plan except one received the lowest grade possible when it comes to plan service.

That abysmal performance shows why I wanted to do these report cards when I became California insurance commissioner. Everyone had complaints about their insurance company, but no one had the data. As every doctor knows, you can’t cure a disease until you diagnose it.

California is now the only state to grade all of its major health insurers, but we expect the rest of the nation to follow. It is only by taking a hard look at the actual facts that insurers can learn where they are not measuring up, and do better.

Or, if they won’t, their customers will be able to find insurers that will. That is the point of making the report cards public. This information has been collected for years, but not always reported publicly at the state level — where it is the most useful.

Despite the bad news, I want to close on a more optimistic note. California’s insurers have participated in this process voluntarily. The fact that insurers have agreed to report to my department shows that they are willing to undergo this public scrutiny, even when it shows their failures. It suggests they are interested in doing better, and national results show that is happening.

That is the expectation we should all have for our health insurers, and we should all keep the pressure on them to get there. We have one more tool, now, to make that happen, and I urge everyone to make use of it.